Detecting feeding problems early

There are many children that suffer from feeding issues.  Most parents and doctors suspect it is only a phase and that if they get hungry enough, they will eat.  This is a mistake especially if the child has sensory problems or the child has hypertonia or hypotonia.  There are many reasons why a child has difficulty with transitioning from breast to bottle or bottle to cup as well as difficulty transitioning from liquids to solids.  Most parents start to notice problems when they go from baby foods to soft table foods.

Parents may report these problems to the doctor at their next well visit only to hear that it is normal and they will eat if they are hungry.  The parent then goes home and tries 20 different cups and different foods and textures without much luck.  The parents then will usually fall into the habit of giving the child only what he/she will eat and/or drink.  The child will continue to gain weight because of the amount of liquid or "junk" foods they are eating.

Time goes on and the child turns 3 and they are very picky and the parents are concerned what to send to preschool or daycare.  When they are eliminating entire food groups or not gaining weight, the physician will then send a referral for a feeding evaluation.  By this time, the child has a learned pattern of eating and they "think" they can only eat certain things out of certain containers and only from certain restaurants, etc.  If the food doesn't look good to them, they will refuse. 

That is why it is crucial when a child is having difficulty transitioning from liquids to solids early on that a referral be made to a qualified speech-language pathologist (SLP) who has had experience in feeding disorders.  The longer a child has eaten a certain way, the longer it takes to tolerate a variety of foods/textures.

When a child has gastric problems such as reflux or delayed emptying, it is imperative that a referral be made to an SLP.  If the child has other diagnosis such as Down Syndrome, it is imperative that a referral be made as soon as 2-4 months of age.  If the therapist can start early, the transitions will be smoother and hopefully without many, if any, problems with eating.

There definitely needs to be more education on detecting early feeding problems among parents and physicians.  I hope that Kidz Zone Pediatric Therapy Services continues to be a place that not only treats the child but also educates all those involved.

Lisa Marshall, MS, CCC-SLP